Department of Health and Social Care

General Practitioners: Burton

Kate Griffiths: To ask the Secretary of State for Health and Social Care, how many GP surgeries in Burton constituency offer appointments in the evening and at weekends.

Kate Griffiths: To ask the Secretary of State for Health and Social Care, what plans the Government has to enable the provision of additional services in GP surgeries in Burton constituency.

Maria Caulfield: The information is not held in the format requested. However, evening and weekend face to face and virtual appointments are offered by East Staffordshire Primary Care Network, with practices providing appointments on a rota system. Weekend appointments are also available from a hub location within the East Staffordshire Clinical Commissioning Group (CCG) area.NHS England and NHS Improvement have advised that work is underway across providers, CCGs and the local authority to optimise care provision in the area. The Staffordshire Integrated Care System continues the launch of general practitioner (GP) referrals into the Community Pharmacist Consultation Service (CPCS) and there are plans for East Staffordshire Primary Care Network, to begin implementing the GP CPCS later in the year.

General Practitioners

Rachael Maskell: To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 27 July 2021 to Question 33266, for what reasons the Government is not collating data on GP appointments which relate to hospital waiting lists for (a) appointments, (b) treatments or (c) surgery to improve patient flow and pressure on the system.

Maria Caulfield: This data is not collected centrally as it is not possible to link general practitioner appointments to other data sets on activity in secondary care. Appointments in the general practice dataset do not have a unique identifier, such as a National Health Service Number, which can link the data to hospital waiting lists.

Accident and Emergency Departments

Damien Moore: To ask the Secretary of State for Health and Social Care, what steps his Department is taking to discourage GPs from making non-urgent referrals to accident and emergency departments.

Maria Caulfield: In 2021/22 the Investment and Impact Fund (IIF) will recognise general practitioner (GP) practices, organised into Primary Care Networks (PCNs), for developing and implementing plans to reduce unnecessary accident and emergency attendances and emergency hospital admissions. In 2021/22 and 2022/23, the IIF will also recognise PCNs for making and implementing plans to increase referrals from general practice to the Community Pharmacist Consultation Service. We have launched the Community Pharmacist Consultation Service which is providing GPs, emergency departments and NHS 111 pathways for referring patients to a consultation with a pharmacist for lower acuity conditions.

Clinical Commissioning Groups: Per Capita Costs

Mr Kevan Jones: To ask the Secretary of State for Health and Social Care, with reference to the proposal by NHS England to incorporate Clinical Commissioning Groups into integrated care systems, whether his Department monitors the per capita expenditure of ICGs by region.

Edward Argar: We have interpreted the hon. Member's question to refer to the intended future monitoring of integrated care boards (ICBs) as the successor to clinical commissioning groups (CCGs). The proposals for ICBs are set out in the current Health and Care Bill. ICBs will be established from April 2022 and will take on the merged allocations from CCGs. The Department does not currently monitor the per capita expenditure of CCGs and there are no plans to monitor the per capita expenditure of ICBs.

Blood Tests: Bottles

Caroline Lucas: To ask the Secretary of State for Health and Social Care, what steps he is taking to increase the number of blood collection tubes available to the NHS; if he will publish the total number of blood collection tubes that were (a) required and (b) available to (i) hospitals, (ii) GP surgeries and (iii) community testing facilities in the most recent period for which that information is available; when he plans for blood testing to resume at the levels previously undertaken prior to the recent shortages of blood collection tubes; what plans and systems he is putting in place to help avoid further future restrictions of blood tests in response to shortages of such diagnostic consumables; and if he will make a statement.

Edward Argar: We have secured in excess of 15 million of additional blood tubes, by importing additional supplies from the European Union and the United States. During August and September, an average of 1.96 million tubes were supplied into hospitals each week against a pre-disruption weekly requirement of 2.04 million. Due to the multiple channels through which blood tubes are provided to different areas of the health and social care system, information on the supply into general practitioner and community testing facilities is not held centrally, as many will receive this via hospitals.The additional stock secured combined with recovery of supply through normal channels has allowed for normal testing to resume from 20 September. The Department is working closely with suppliers, NHS England, the devolved administrations and the National Health Service to enhance future resilience through strategic planning, rebuilding local and national stockpiles, introduction and validation of supplier product and the adoption of best practice within the health system to make best use of the available resources.

Members: Correspondence

Rosie Cooper: To ask the Secretary of State for Health and Social Care, when he plans to respond to the letter dated 16 April 2021 from the hon. member for West Lancashire on the backlog in cancer appointments due to the covid-19 outbreak, reference ZA56223.

Edward Argar: We replied to the hon. Member on 29 September 2021.

Health Services: Rural Areas

Anne Marie Morris: To ask the Secretary of State for Health and Social Care, what steps he is taking to tackle the challenges of providing healthcare in remote and rural areas.

Edward Argar: The development of integrated care systems will create a new method of responding to and tackling local challenges, such as delivering healthcare in remote and rual areas. NHS England continues to work with trusts to develop a standard model of delivery in smaller acute hospitals which serve rural populations as part of the NHS Long Term Plan.

Health Services

Rachael Maskell: To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of a population health model of strategic leadership in order that communities can determine local health priorities.

Edward Argar: We have no plans to make such an assessment. The Health and Care Bill establishes new National Health Service bodies known as integrated care boards (ICBs) and requires the creation of integrated care partnerships (ICP). Each ICB and their partner local authorities will be required to establish an ICP, bringing together health, social care, public health, and other perspectives, such as social care and housing providers, to develop a strategy to address the needs of the population in the area.

Gender Recognition: Drugs

Anneliese Dodds: To ask the Secretary of State for Health and Social Care, what steps he has taken to ensure that people recommended gender transition medication by a Gender Identity Clinic in England receive that medication promptly and consistently, whether or not their GP has the specialist knowledge and confidence to be involved in prescribing it and monitoring the patient.

Maria Caulfield: Timely and consistent access to gender transition medication is promoted by through guidance issued to practitioners, with standards upheld through regulation by the Care Quality Commission. Guidance has been published by the General Medical Council to ensure transgender patients are able to receive high quality, quick and effective care when accessing general practitioner (GP) services for medication. This guidance for GPs covers transgender patient pathways and entering into a shared care agreement with a gender dysphoria clinic for the purpose of prescribing medication. This ensures that support is in place for any change in medication or in other circumstance, so GPs are confident in prescribing any medication the patient needs.

NHS: Expenditure

Jonathan Ashworth: To ask the Secretary of State for Health and Social Care, with reference to the Answer of 28 January 2020 to Question 4740 on NHS: Expenditure, how much NHS England and clinical commissioning groups have spent in aggregate on (a) mental health services, (b) acute health services, (c) social care services, (d) primary care services and (e) other main areas of spending in each year since 2015-16; and how much those organisations plan to spend in aggregate in each of those areas in 2021-22.

Edward Argar: The information requested is shown in the following table. 2015-16 £ billion2016-17 £ billion2017-18 £ billion2018-19 £ billion2019-20 £ billionSpecialised services14.815.416.417.218.5Primary medical care8.79.19.49.710.6Community services7.17.37.47.58.1Continuing care4.34.74.64.75.0Clinical commissioning group (CCG) acute38.240.141.442.945.9CCG core mental health7.37.68.18.59.3Other18.917.818.318.618.4Total programme spend99.4102.0105.5109.1115.7  Of which: Payments to local authorities3.13.13.33.53.6 NHS England and NHS Improvement have advised that the 2020-21 accounts are currently being finalised.Planning for budgets in the second half of 2021-22 and is underway therefore information on expenditure in these areas in not yet available.

Menorrhagia: Steroid Drugs

Jim Shannon: To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of the University of Edinburgh's recent study which found that a common steroid could reduce heavy menstrual bleeding.

Maria Caulfield: NHS England and NHS Improvement will await guidance from the National Institute for Health and Care Excellence (NICE) and the Royal College of Obstetricians and Gynaecologists on whether the findings from this research should be used to develop best practice care. Currently clinical commissioning groups have a duty to give due regard to implementing NICE’s guidance. NHS England and NHS Improvement encourage all providers to adopt NICE’s guideline NG88, ‘Heavy menstrual bleeding: assessment and management’, which covers assessing and managing heavy menstrual bleeding and also helps healthcare professionals to investigate the causes.

Coronavirus: Vaccination

Damian Green: To ask the Secretary of State for Health and Social Care, what plans he has to ensure that UK citizens fully vaccinated outside of the UK have full rights of travel to and from the UK; and if he will make a statement.

Maggie Throup: All United Kingdom citizens and those with the rights to reside in the UK who are fully vaccinated outside the UK have full rights to travel.

Health Services and Social Services: Influenza

Mr Mark Harper: To ask the Secretary of State for Health and Social Care whether, with reference to the consultation entitled Making vaccination a condition of deployment in the health and wider social care sector, whether he has plans to extend domestic vaccine certification to include flu vaccines.

Maggie Throup: The consultation ‘Making vaccination a condition of deployment in the health and wider social care sector’ relates specifically to health and care workers, not to wider use of domestic vaccine certification. There are no plans to extend domestic certification to include flu vaccination.

Travel: Quarantine

Rachael Maskell: To ask the Secretary of State of Health and Social Care, what discussions he has had with suppliers of quarantine accommodation on environmental standards in that accommodation; and what plans he has to terminate contracts where rats have been found within that accommodation.

Rachael Maskell: To ask the Secretary of State for Health and Social Care, what guidance his Department has published for covid-19 quarantine hotels on cleaning hotel rooms (a) during and (b) after a person's stay; and whether his Department has issued guidance suggesting that quarantine hotels leave rooms vacant for 10 days between guests.

Maggie Throup: We work closely with the hospitality sector providing quarantine accommodation and continue to monitor the operation of the managed quarantine service. CTM is the Government’s hotel quarantine service supplier. To ensure all our managed quarantine hotels are safe environments, we have standard operating procedures (SOPs), testing and infection prevention control processes for staff and guests. Each hotel has dedicated Departmental on-site liaison officers who monitor compliance with the SOPs and report back compliance issues, breaches, opportunities to improve services and other matters including health and safety breaches.In a particular case where a resident had observed a rodent, the guest was moved and subsequently an environmental health officer upon inspection gave the facility a five-star rating, which is the highest rating that can be achieved. While a single or exceptional instance of non-compliance does not automatically trigger a contract termination, but the Department’s contract management and commercial teams do monitor standards and performance and will terminate contracts where performance or standards remain below what is required. Contracts are designed to terminate in the event of sub-optimal performance.We require hotels to ensure that rooms are cleaned and COVID-19 secure after a positive case. After a guest checks out the room is left for 24 hours prior to accessing it to ‘deep clean’. Strict protocols should be adhered to by all hotels by following the World Health Organization’s guidance on cleanliness.

Travel: Quarantine

Rachael Maskell: To ask the Secretary of State for Health and Social Care, how many quarantine hotels have had sightings of rats (a) in the bedrooms, (b) in the common areas and (c) in staff areas, including kitchens; and what steps he is taking to tackle the presence of rats in those hotels.

Rachael Maskell: To ask the Secretary of State for Health and Social Care, what assessment he has made of the safety of children staying in quarantine hotels including where there are rats in that accommodation

Rachael Maskell: To ask the Secretary of State for Health and Social Care, for what reason residents have not been moved to alternative accommodation after rats have been found to be present in their existing quarantine hotel.

Rachael Maskell: To ask the Secretary of State for Health and Social Care, if his Department will put in place contractual arrangements to disapply accommodation fees and pay compensation to residents who have witnessed a rat in their room in a quarantine hotel in connection with covid-19 travel restrictions.

Maggie Throup: A single complaint was reported in one managed quarantine facility. Following this incident, a full risk assessment was carried out by the hotel, including introduction of improved vermin controls and subsequently an environmental health officer upon inspection gave the facility a five-star rating, which is the highest rating that can be achieved. There has been no indication of vermin or further sightings reported by staff or guests in other managed quarantine hotels.We work closely with the hospitality sector providing quarantine accommodation and continue to monitor the operation of the managed quarantine service to ensure it remains appropriate Our facilities team work directly with local environmental health teams to ensure that the accommodation offered meets the appropriate hygiene and cleanliness standards and is safe for all guests. In this specific instance, the guest and other occupants were not removed from the facility to prevent the risk to public health and potential transmission to other locations.To ensure all our managed quarantine hotels are safe environments, we have standard operating procedures (SOPs), testing and infection prevention control processes for staff and guests. Each hotel has dedicated Departmental on-site liaison officers who monitor compliance with SOPs and report back compliance issues, breaches, opportunities to improve services and other matters including health and safety breaches.Within the Managed Quarantine Service (MQS), we have introduced an assessed refund policy. All complaints are dealt with on a case-by-case basis. Where appropriate we give guests full or partial refunds where it is evidentially proven that the service we offer has not met MQS facility standards.

Dementia: Research

Mr Tanmanjeet Singh Dhesi: To ask the Secretary of State for Health and Social Care, whether he plans to increase funding to support dementia research.

Maria Caulfield: We are currently working on ways to significantly increase further research on dementia at all stages including medical and care interventions. The Department funds research on health and social care through the National Institute for Health Research (NIHR). The usual practice of NIHR is not to ring-fence funds for expenditure on particular topics. The NIHR welcomes funding applications for research into any aspect of human health including dementia. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

Motor Neurone Disease: Research

Paul Girvan: To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential benefits of increased investment in motor neurone disease research for other neurological conditions.

Maria Caulfield: No specific assessment has been made. The Government makes funding available for research but does not generally ring-fence funds for particular disease areas. Research proposals in all areas compete for the funding available. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

Fluoride: Drinking Water

Rosie Cooper: To ask the Secretary of State for Health and Social Care, with reference to the findings of the paper entitled Assessment of Lake Water Quality and Eutrophication Risk in an Agricultural Irrigation Area: A Case Study of the Chagan Lake in Northeast China published by Xuemei Liu et al on 14 November 2019, what assessment his Department has made of the implications for its policies on water fluoridation of the research findings that increased environmental fluoride levels contribute significantly to eutrophication.

Maria Caulfield: The Department for Environment, Food and Rural Affairs has advised that eutrophication of lakes is driven by excess nutrients, phosphorus and nitrogen, the main sources of which are agriculture and sewage effluent. Fluoridation of drinking water supplies is not considered to have an effect and the low levels of fluoride that occur naturally in most waters in the United Kingdom are not felt to be an influence on the risks and impacts of eutrophication.

Dermatitis: Mental Health Services

Mr Nicholas Brown: To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase mental health services for those suffering with eczema.

Mr Nicholas Brown: To ask the Secretary of State for Health and Social Care, what steps his Department is taking to support National Eczema Week.

Maria Caulfield: Where appropriate, patients can be referred to specialists in psychodermatology. the treatment of skin diseases using psychological techniques, through a network of specialised clinicians. The specialised dermatology Clinical Reference Group is currently reviewing the standards of care for psychodermatology, working closely with Psychodermatology UK. As part of the Mental Health Recovery Action Plan, the Government is accelerating key commitments in the NHS Long Term Plan, investing £110 million to expand Improving Access to Psychological Therapies (IAPT) services. IAPT - Long Term Conditions services have been established across the country to support integrated pathways between IAPT services and physical health pathways for people with long term conditions, including eczema.Whilst we had no specific events related to National Eczema Week, we recognise and commend the work of the voluntary and community sector organisations, who continue to raise awareness of eczema and the issues facing those living with the condition.

Cabinet Office

Conditions of Employment: Brexit

Rachael Maskell: To ask the Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, if he will make it his policy to ensure that workers' rights are not diminished as a result of the commission looking at regulation following the UK's departure from the EU.

Rachael Maskell: To ask the Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, if he will make it his policy to ensure that environmental protections are not diminished as a result of the commission looking at regulation following the UK's departure from the EU.

Michael Ellis: The Government is committed to high standards of workers’ rights and environmental protections. The initiative referred to by the hon. Member is about ensuring that we have a regulatory environment which is the right fit for the UK as an independent nation.

Women and Equalities

Government Equalities Office: Departmental Responsibilities

Kim Johnson: To ask the Minister for Women and Equalities, what assessment she has made of the impact of her role as Secretary of State for Foreign, Commonwealth and Development Affairs on her ability to deliver her Department's Equalities agenda.

Elizabeth Truss: The priorities of the Foreign, Commonwealth and Development Office and the Equality Hub are closely aligned: both are working to promote the safety and empowerment of women and girls; share a commitment to advance LGBT equality through the Global LGBT Conference; are supporting our global leadership on disability rights; and collaborate across many other areas of work as we advance core freedoms and liberties across the world.Whether it be banning the abhorrent practice of conversion therapy, ending violence against women and girls, or improving equality of opportunity in education here in the UK and internationally, joint working towards common goals strengthens our ability to deliver equality for all.More broadly, having Ministers based across Government in the Department for Work and Pensions, the Department for International Trade, and the Department for Levelling Up, Housing and Communities will support our ambitions to build back fairer from COVID-19 and level up across the country.